Chapter 11 - Cardiovascular System

Arrhythmias

Arrhythmias

Abnormal heart rhythms (dysrhythmias).

Bradycardia and heart block (atrioventricular block)

Failure of proper conduction of impulses from the Sinoatrial node (SA node) though the Atrioventricular node (AV node) to the Atrioventricular bundle (bundle of his).

Cardiac pacemaker

Battery-powered apparatus implanted under the skin with leads placed on the heart. (Keeps heart beating at proper rate)

Biventricular pacemaker

Device enabling ventricles to beat together so that more blood is pumped out of the heart. (Treats delays and abnormalities in ventricular contractions.)

Flutter

Rapid but regular contractions, usually of the atria.

Fibrillation

Very rapid, random, inefficient, and irregular contractions of the heart. (350 Beats or more per minute)

Atrial Fibrillation (A-Fib)(AF)

Most common type of cardiac arrhythmia.

Palpitations

Pounding,racing heartbeats. Uncomfortable sensations in the chest related to cardiac arrhythmias, such as premature ventricular contractions (PVCs)

Paroxysmal AF

Irregular heartbeats occur periodically and episodically

Permanent/persistent AF

Irregular heartbeats continue indefinitely. At much greater risk for a stroke.

NOACs (novel oral anticoagulants)

Blood thinner that can reduce the risk of a stroke.

Ventricular fibrillation (V-fib)

Electrical impulses become chaotic and the heart's pump has an incorrect rhythm.

Cardiac arrest

Sudden, unexpected stoppage of heart action, often leading to sudden cardiac death.

Defibrillation

Application of an electric shock to the myocardium through the chest wall to restore normal cardiac rhythm

Digoxin, beta-blockers, calcium channel blockers

Convert fibrillation to normal sinus rhythm. (Medications)

Implantable cardioverter-defibrillator (ICD)

Small electrical device that is implanted in the chest to sense arrhythmias and terminate them with electrical shock.

Automatic external-defibrillator (AED)

An external device attached to the chest with which to shock the heart if in asystole or arrhythmia in hopes of restarting or re-establishing a normal heart rhythm

Catheter ablation

Treatment of cardiac arrhythmias in which energy is transmitted through a catheter to remove the pathway of an abnormal heart rhythm

Congenital heart disease

Abnormalities in the heart at birth

Coarctation of the aorta (CoA)

Narrowing (coarctation) of the aorta

Patent ductus arteriosus (PDA)

Passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth

Septal defects

Small holes in the wall between the atria (atrial septal defects) or the ventricles (ventricular septal defects)

Tetralogy of Fallot

Congenital malformation involving four (tetra-) distinct heart defects

Pulmonary artery stenosis

Pulmonary artery is narrow or obstructed. (Tetralogy o Fallot)

Ventricular septal defect

Large hole between two ventricles lets venous blood pass from the right to the left ventricle and out to the aorta without oxygenation (Tetralogy of Fallot)

Shift of the aorta to the right

Aorta overrides the interventricular septum. oxygen-poor blood passes from the right ventricle to the aorta. (Tetralogy of Fallot)

Hypertrophy of the right ventricle

Myocardium works harder to pump blood through a narrowed pulmonary artery. (Tetralogy of Fallot)

Cyanosis

A bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood.

Congestive heart failure (CHF)

Heart is unable to pump its required amount of blood

Systolic CHF

Left ventricular dysfunction results in a low ejection fraction

Diastolic CHF

The heart can contract normally but is "stiff" or less compliant when relaxed or filling with blood

Pulmonary edema

accumulation of fluid in the lungs

Angiotensin-converting enzyme (ACE) inhibitors (type 1), beta blockers, digoxin

Treatments that increase excretion of water and sodium by the kidney.

Left ventricular assist device (LVAD)

A booster pump implanted in the abdomen with a cannula (tube) inserted into the left ventricle. It pumps blood out of the heart to all parts of the body.

Coronary artery disease (CAD)

Disease of the arteries surrounding the heart

Atherosclerosis

Condition in which fatty deposits called plaque build up on the inner walls of the arteries

Thrombotic occlusion

Blocking of an artery by a thrombus (blood clot)

Necrosis

death of tissue

Myocardial infarction (MI)

Death of cardiac muscle due to ischemia

Acute coronary syndromes (ACSs)

Conditions caused by myocardial ischemia

Unstable angina

Chest pain at rest or chest pain of increasing frequency

myocadial infarction

Occurs when myocardial ischemia is sustained, resulting in death of myocardial cells (necrosis)

Nitroglycerin

Nitrate drug used in the treatment of angina

Nitrates

Special compounds containing nitrogen and oxygen

Aspirin

Drug to prevent clumping of platelets

Beta blockers

Drug given to reduce the force and speed of the heartbeat and to lower blood pressure.

ACE inhibitors

Drug given to reduce high blood pressure and the risk of a future heart attack even if the patient isn't hypertensive.

Calcium channel blockers

Drug given to relax muscles in the blood vessels.

Statins

Drug given to lower cholesterol

Coronary artery bypass grafting (CABG)

Vessels taken from the patient's legs or chest are connected to coronary arteries to make detours around blockages

Percutaneous coronary intervention (PCI)

A procedure in which a balloon-tipped catheter is placed in a coronary artery, and one of several methods is employed to reduce blockage within the artery. Stents are put in place.

Endocarditis

Inflammation of the inner lining of the heart.

Hypertensive Heart Disease

High blood pressure affecting the heart.

Mitral valve prolapse (MVP)

Improper closure of the mitral valve

Murmur

Extra heart sound, heard between normal beats

Pericarditis

Inflammation of the membrane (pericardium) surrounding the heart.

Rheumatic Heart Disease

Heart disease caused by rheumatic fever (childhood disease that follows pharyngitis)

Aneurysm

Local widening (dilation of an arterial wall.

Deep vein thrombosis

Blood clot (thrombus) forms in a large vein, usually in the lower limb.

Hypertension (HTN)

High blood pressure.

Peripheral arterial disease (PAD)

Blockage of arteries carrying blood to the legs, arms, kidneys and other organs.

Raynaud’s disease

Recurrent episodes of pallor and cyanosis primarily in fingers and toes.

Varicose veins

Abnormally swollen and twisted veins, usually occurring in the legs.

BNP Test

Measurement of BNP (Brain natriuretic peptide: elevated in patients with heart failure) in the blood.

Cardiac biomarkers

Chemicals are measured in the blood as evidence of a heart attack.

Lipid tests (lipid profile)

Measurement of cholesterol and triglycerides (fats) in a blood sample.

Lipoprotein electrophoresis

Lipoproteins (combinations of fat and protein) are physically separated and measured in a blood sample.

Angiography

X-ray imaging of blood vessels after injection of contrast medium.

Arteriography

X-ray imaging of arteries after injection of contrast via a catheter into the aorta or an artery.

Computed tomography angiography (CTA)

Three-dimensional x-ray images of the heart and coronary arteries using computed tomography (64 slice CT scanner)

Digital subtraction angiography (DSA)

Video equipment and a computer produce x-ray images of blood vessels.

Doppler ultrasound studies

Sound waves measure blood flow within blood vessels.

Echocardiography (ECHO)

Echoes generated by high-frequency sound waves produce images of the heart.

Positron emission tomography (PET) scan

Images show blood flow and myocardial function following uptake of radioactive glucose.

Technetium Tc 99m sestamibi scan

Technetium Tc (9m sestamibi injected intravenously is taken up in cardiac tissue, where is detected by scanning.

Thallium 201 scan

Concentration of radioactive thallium is measured to give information about blood supply to the heart muscle.

Cardiac MRI

Images of the heart are produced using radio wave energy in a magnetic field

Cardiac catherization

Thin, flexible tube is guided into the heart via a vein or an artery.

Electrocardiography (ECG)

Recoding of electricity flowing through the heart.

Holter monitoring

An ECG (electrocardiography) device is worn during a 24-hour period to detect cardiac arrythmias.

Stress test

Exercise tolerance test (ETT) determines the heart’s response to physical exertion (stress)

Endarterectomy

Surgical removal of plaque from the inner layer of an artery.

Extracorporeal circulation

Heart-lung machine diverts blood from the heart and lungs while the heart is repaired.

Heart transplantation

Donor heart is transferred to a recipient

Thrombolytic therapy

Drugs to dissolve clots are injected into the bloodstream of patients with coronary thrombosis

Transcatheter aortic valve replacement (TAVR)

Placement of a balloon-expandable aortic heart valve into the body via a catheter.

Thrill

Vibration felt over an area of turmoil in blood flow (as a blocked artery)

Petechiae

Small, pinpoint hemorrhages

Vegetations

Clumps of platelets, clotting proteins, microorganisms, and red blood cells on diseased heart valves.

Claudication

Pain, tension, and weakness in a leg after walking has begun, but absence of pain at rest.

Cardiac tamponade

Pressure on a heart caused by fluid in the pericardial space.